PMID- 22927038
OWN - NLM
STAT- MEDLINE
DCOM- 20140213
LR  - 20191210
IS  - 1097-0096 (Electronic)
IS  - 0091-2751 (Linking)
VI  - 41
IP  - 6
DP  - 2013 Jul-Aug
TI  - Exploratory analysis of estimated acoustic peak rarefaction pressure, 
      recanalization, and outcome in the transcranial ultrasound in clinical 
      sonothrombolysis trial.
PG  - 354-60
LID - 10.1002/jcu.21978 [doi]
AB  - PURPOSE: Acoustic peak rarefaction pressure (APRP) is the main factor that 
      influences ultrasound-enhanced thrombolysis. We sought to determine whether 
      recanalization rate and functional outcomes in the Transcranial Ultrasound in 
      Clinical SONothrombolysis (TUCSON) trial could be predicted by estimated in vivo 
      APRP. METHODS: We developed an acoustic attenuation model to estimate the in vivo 
      APRP at the arterial occlusion site in each subject of the TUCSON trial with CT 
      scans eligible for measurements. Variables included temporal bone thickness, 
      depth of arterial occlusion site, and average attenuation of skin and brain 
      tissues. Recanalization was defined as partial or complete using the Thrombolysis 
      in Brain Infarction flow grades. Functional independence was assessed at 3 months 
      using the modified Rankin Scale score (mRS, 0-1). RESULTS: APRP was calculated in 
      20 acute ischemic stroke patients treated with sonothrombolysis (mean age, 64 +/- 
      15 years, 65% men; median NIHSS score, 13; IQR, 6-17). The mean APRP was 30.2 +/- 
      15.5 kPa (range, 8-68 kPa). Patients with persisting occlusion had 
      nonsignificantly lower APRP than patients with partial or complete recanalization 
      (25.2 +/- 8.0 versus 32.3 +/- 17.7 kPa; p = 0.228). Patients who were functionally 
      independent at 3 months had nonsignificantly higher APRP than patients with worse 
      outcome (35.1 +/- 19.5 versus 25.9 +/- 11.2 kPa; p = 0.217). CONCLUSIONS: Our 
      exploratory analysis suggests a potentially important role of successful energy 
      delivery to augment thrombolysis with 2-MHz ultrasound in acute ischemic stroke 
      patients.
CI  - Copyright (c) 2012 Wiley Periodicals, Inc.
FAU - Barlinn, Kristian
AU  - Barlinn K
AD  - Comprehensive Stroke Center, University of Alabama Hospital, Birmingham, AL, USA.
FAU - Tsivgoulis, Georgios
AU  - Tsivgoulis G
FAU - Molina, Carlos A
AU  - Molina CA
FAU - Alexandrov, Dmitri A
AU  - Alexandrov DA
FAU - Schafer, Mark E
AU  - Schafer ME
FAU - Alleman, John
AU  - Alleman J
FAU - Alexandrov, Andrei V
AU  - Alexandrov AV
CN  - TUCSON Investigators
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20120828
PL  - United States
TA  - J Clin Ultrasound
JT  - Journal of clinical ultrasound : JCU
JID - 0401663
RN  - 0 (Fibrinolytic Agents)
RN  - EC 3.4.21.68 (Tissue Plasminogen Activator)
SB  - IM
MH  - Aged
MH  - Biomechanical Phenomena
MH  - Cerebral Infarction/*diagnostic imaging/therapy
MH  - Combined Modality Therapy
MH  - Female
MH  - Fibrinolytic Agents/therapeutic use
MH  - Follow-Up Studies
MH  - Humans
MH  - Logistic Models
MH  - Male
MH  - Mechanical Thrombolysis/*methods
MH  - Microspheres
MH  - Middle Aged
MH  - Models, Biological
MH  - Pressure
MH  - Recovery of Function
MH  - Retrospective Studies
MH  - Single-Blind Method
MH  - Thrombolytic Therapy/methods
MH  - Tissue Plasminogen Activator/therapeutic use
MH  - Tomography, X-Ray Computed
MH  - Treatment Outcome
MH  - *Ultrasonography, Doppler, Transcranial
MH  - *Ultrasonography, Interventional
EDAT- 2012/08/29 06:00
MHDA- 2014/02/14 06:00
CRDT- 2012/08/29 06:00
PHST- 2012/01/25 00:00 [received]
PHST- 2012/08/02 00:00 [accepted]
PHST- 2012/08/29 06:00 [entrez]
PHST- 2012/08/29 06:00 [pubmed]
PHST- 2014/02/14 06:00 [medline]
AID - 10.1002/jcu.21978 [doi]
PST - ppublish
SO  - J Clin Ultrasound. 2013 Jul-Aug;41(6):354-60. doi: 10.1002/jcu.21978. Epub 2012 
      Aug 28.